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IOWA HEALTH CARE FACILITY (135C) RECORD CHECK Form C

IOWA HEALTH CARE FACILITY (135C) RECORD CHECK Form C 2026

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The document outlines the procedures and forms required for conducting criminal history checks and dependent adult abuse information requests in Iowa. It includes sections for requesting a criminal history check, authorizing the release of dependent adult abuse information, and evaluating individuals with prior convictions or founded abuse. Additionally, it details tenant rights in assisted living programs, employer reporting requirements for new hires, and guidelines for completing tax withholding forms. The document emphasizes legal provisions regarding the handling of sensitive information and the consequences of misuse.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the ACCOUNT NUMBER at the top of the form. This is essential for tracking your request.
In the 'TO' section, ensure you accurately fill in the address of the Iowa Division of Criminal Investigation.
Complete the 'FROM' section with your contact information, including phone and fax numbers.
In the REQUEST section, type or print legibly the last name, date of birth, first name, middle name, and maiden name if applicable. Ensure mandatory fields are filled out correctly.
Sign where indicated as the requester and include your date of signature.
Review all sections for accuracy before submitting. Use our platform's features to save and share your completed form easily.

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